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宫颈管内高级别鳞状上皮内病变的血卟啉单甲醚光动力疗法用于年轻女性。

Hiporfin-photodynamic therapy for high-grade squamous intraepithelial lesions of the endocervical canal in young women.

机构信息

Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, No.1120 Lianhua Road, Futian district, Shenzhen, 518036, Guangdong, China.

Institute of Obstetrics and Gynecology, Shenzhen Peking University-Hong Kong University of Science and Technology (PKU-HKUST) Medical Center, No.1120 Lianhua Road, Futian district, Shenzhen, 518036, Guangdong, China.

出版信息

Sci Rep. 2024 Nov 18;14(1):28423. doi: 10.1038/s41598-024-79980-1.

Abstract

The objective of this prospective study was to assess the efficacy of Hiporfin-photodynamic therapy (PDT) int the treatment of young women diagnosed with high-grade squamous intraepithelial lesions (HSIL) of the endocervical canal. This study included 14 patients aged 30 ± 4.2 years (range 21-37) with HSIL of the cervical canal, treated at our hospital from August 2021 to June 2023. Hiporfin (2 mg/kg) was administered intravenously and laser irradiation with a 630 nm wavelength was performed on the cervical canal and cervical surface 48-72 h later. All patients had been observed for at least 12 months. 64.3% (9/14) were nulliparous. The complete response (CR) rate of cervical canal involvement was 100.0% (14/14) at 3-6 months. Pre-PDT, all patients (14/14) tested positive for high-risk human papilloma virus (HR-HPV). The HPV eradication rate was 64.3% (9/14) at 3-6 months and 85.7% (12/14) at 12 months. No serious adverse effects were observed in patients during or after PDT. No recurrence was noted during the long-time follow-up. 6 patients who planned to get pregnant achieved 6 pregnancies including 1 spontaneous abortion, 2 term pregnancies, and 3 ongoing pregnancies. No fetal loss occurred due to cervical incompetence. Hiporfin-PDT may be a promising, fertility-preserving treatment for HSIL of the endocervical canal in young women.

摘要

本前瞻性研究旨在评估海姆泊芬光动力疗法(PDT)治疗年轻女性子宫颈管高级别鳞状上皮内病变(HSIL)的疗效。该研究纳入了 2021 年 8 月至 2023 年 6 月在我院接受治疗的 14 例年龄为 30±4.2 岁(21-37 岁)的子宫颈管 HSIL 患者。静脉内给予海姆泊芬(2mg/kg),48-72 小时后,用 630nm 波长激光照射子宫颈管和宫颈表面。所有患者均至少随访 12 个月。64.3%(9/14)为未产妇。3-6 个月时,子宫颈管受累的完全缓解(CR)率为 100.0%(14/14)。Pre-PDT 时,所有患者(14/14)均检测到高危型人乳头瘤病毒(HR-HPV)阳性。3-6 个月时,HPV 清除率为 64.3%(9/14),12 个月时为 85.7%(12/14)。PDT 期间或之后,患者均未观察到严重不良反应。长时间随访期间,无复发。6 例计划怀孕的患者共获得 6 例妊娠,包括 1 例自然流产、2 例足月妊娠和 3 例持续妊娠。无因宫颈机能不全导致的胎儿丢失。海姆泊芬-PDT 可能是一种有前途的、保留生育力的年轻女性子宫颈管 HSIL 治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/afa6/11574053/367bf41faaad/41598_2024_79980_Fig1_HTML.jpg

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